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Area of Science:

  • Public Health
  • Healthcare Management
  • Addiction Medicine

Background:

  • Opioid use disorder (OUD) is a critical public health crisis requiring expanded treatment options.
  • Primary care settings are a promising venue for increasing access to medication treatment for opioid use disorder (MOUD).
  • Learning collaboratives (LCs) are an evidence-based strategy to facilitate MOUD implementation in primary care.

Purpose of the Study:

  • To develop and evaluate a multidisciplinary MOUD learning collaborative in underserved primary care clinics.
  • To assess the impact of the collaborative on clinics' capacity to implement or improve MOUD programs.
  • To identify barriers and enablers to MOUD program success in primary care.

Main Methods:

  • A mixed-methods approach was used to study a collaborative involving six underserved primary care clinics.
  • Clinics received training and support to enhance their MOUD programs.
  • Pre- and post-collaborative assessments measured perceived competence and quality improvement goals.

Main Results:

  • Approximately 80% of participating clinics achieved their quality improvement goals.
  • Perceived competence in implementing/improving MOUD programs significantly increased post-collaborative (2.80 to 6.33/10, P=.02).
  • Stigma surrounding OUD was a consistent barrier, while trainee interest, leadership support, and dedicated MOUD teams were key enablers.

Conclusions:

  • The learning collaborative effectively enhanced MOUD program implementation and improvement in primary care.
  • Addressing stigma through additional staff/clinician training is crucial for MOUD success.
  • Sustained organizational support is vital for long-term MOUD program effectiveness.